TY - JOUR
T1 - Prevalence and determinants of metabolic syndrome in 2338 childhood cancer survivors
T2 - A Dutch Childhood Cancer Survivor LATER 2 study
AU - Bolier, Melissa
AU - de Winter, Demi T.C.
AU - Pluimakers, Vincent G.
AU - Fiocco, Marta
AU - van den Berg, Sjoerd A.A.
AU - Bresters, Dorine
AU - van Dulmen-den Broeder, Eline
AU - van der Heiden-van der Loo, Margriet
AU - Höfer, Imo
AU - Janssens, Geert O.
AU - Kremer, Leontien C.M.
AU - Loonen, Jacqueline J.
AU - Louwerens, Marloes
AU - van der Pal, Heleen J.
AU - Pluijm, Saskia M.F.
AU - Tissing, Wim J.E.
AU - van Santen, Hanneke M.
AU - de Vries, Andrica C.H.
AU - van der Lely, Aart Jan
AU - van den Heuvel-Eibrink, Marry M.
AU - Neggers, Sebastian J.C.M.M.
N1 - Publisher Copyright:
© 2025 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.
PY - 2025/1/2
Y1 - 2025/1/2
N2 - Background: Because the occurrence of metabolic syndrome (MetS) might contribute to childhood cancer survivor’s excess risk of cardiovascular disease, the authors assessed the prevalence and determinants of MetS in the Dutch Childhood Cancer Survivor Study (DCCSS-LATER2) cohort. Methods: In total, 2338 adult childhood cancer survivors (CCS) were cross-sectionally assessed for the prevalence of MetS, using the Lifelines cohort (N = 132,226 adults without a history of cancer) as references. The prevalence of MetS was clinically assessed using existing classifications, as well as an alternative method using dual-energy x-ray absorptiometry fat% instead of waist circumference to define abdominal adiposity. Logistic regression models, adjusted for age and sex, were used to investigate the association between the presence of MetS and both cohorts. Demographic, lifestyle, and treatment determinants of MetS were identified through multivariable logistic regression. Results: The survivor cohort (median age, 34.7 years, median follow-up time, 27.1 years) showed increased adjusted odds ratio (aOR) for MetS (modified National Cholesterol Education Program Adult Treatment Panel III criteria), as compared to the reference cohort (aOR, 2.07; 95% confidence interval [CI], 1.85–2.32). Compared to these criteria, the alternative method identified 57 additional survivors with MetS (395 of 2070 [19.1%] vs. 452 of 1960 [23.1%], respectively). Age (odds ratio [OR], 1.07; 95% CI, 1.04–1.10, per year increase), smoking (OR, 1.46; 95% CI, 1.04–2.04), low physical activity (OR, 1.48; 95% CI, 1.05–2.09), abdominal radiotherapy (OR, 2.13; 95% CI, 1.01–4.31; >30 Gy), cranial radiotherapy (OR, 2.89; 95% CI, 1.67–4.96; 1–25 Gy; and OR, 2.44; 95% CI, 1.30–4.47; >25 Gy), total body irradiation (OR, 6.17; 95% CI, 3.20–11.76), and underlying central nervous system tumor (OR, 1.78; 95% CI, 1.21–2.60) were associated with MetS. Conclusion: The high risk of MetS in CCS, combined with several potential modifiable factors, underscores the need for timely identification and intervention strategies to mitigate the long-term cardiovascular risks in CCS.
AB - Background: Because the occurrence of metabolic syndrome (MetS) might contribute to childhood cancer survivor’s excess risk of cardiovascular disease, the authors assessed the prevalence and determinants of MetS in the Dutch Childhood Cancer Survivor Study (DCCSS-LATER2) cohort. Methods: In total, 2338 adult childhood cancer survivors (CCS) were cross-sectionally assessed for the prevalence of MetS, using the Lifelines cohort (N = 132,226 adults without a history of cancer) as references. The prevalence of MetS was clinically assessed using existing classifications, as well as an alternative method using dual-energy x-ray absorptiometry fat% instead of waist circumference to define abdominal adiposity. Logistic regression models, adjusted for age and sex, were used to investigate the association between the presence of MetS and both cohorts. Demographic, lifestyle, and treatment determinants of MetS were identified through multivariable logistic regression. Results: The survivor cohort (median age, 34.7 years, median follow-up time, 27.1 years) showed increased adjusted odds ratio (aOR) for MetS (modified National Cholesterol Education Program Adult Treatment Panel III criteria), as compared to the reference cohort (aOR, 2.07; 95% confidence interval [CI], 1.85–2.32). Compared to these criteria, the alternative method identified 57 additional survivors with MetS (395 of 2070 [19.1%] vs. 452 of 1960 [23.1%], respectively). Age (odds ratio [OR], 1.07; 95% CI, 1.04–1.10, per year increase), smoking (OR, 1.46; 95% CI, 1.04–2.04), low physical activity (OR, 1.48; 95% CI, 1.05–2.09), abdominal radiotherapy (OR, 2.13; 95% CI, 1.01–4.31; >30 Gy), cranial radiotherapy (OR, 2.89; 95% CI, 1.67–4.96; 1–25 Gy; and OR, 2.44; 95% CI, 1.30–4.47; >25 Gy), total body irradiation (OR, 6.17; 95% CI, 3.20–11.76), and underlying central nervous system tumor (OR, 1.78; 95% CI, 1.21–2.60) were associated with MetS. Conclusion: The high risk of MetS in CCS, combined with several potential modifiable factors, underscores the need for timely identification and intervention strategies to mitigate the long-term cardiovascular risks in CCS.
KW - childhood cancer survivor
KW - late effects
KW - metabolic syndrome
KW - survivorship
UR - http://www.scopus.com/inward/record.url?scp=85214110123&partnerID=8YFLogxK
U2 - 10.1002/cncr.35681
DO - 10.1002/cncr.35681
M3 - Article
C2 - 39748458
AN - SCOPUS:85214110123
SN - 0008-543X
VL - 131
JO - Cancer
JF - Cancer
IS - 1
M1 - e35681
ER -